耳后推进皮瓣联合耳甲软骨支撑法矫正重度隐耳畸形  

Correction of severe cryptotia malformation with retroauricular advancement skin flap associated with the concha auriculae cartilage support method

作　　者：王莨越 何云帆[1] 黎小间[1] 鲁峰[1] WANG Gen-yue;HE Yun-fan;LI Xiao-jian;LU Feng(Department of Plastic and Reconstructive Surgery,Nanfang Hospital of Southern Medical University,Guangzhou 510080,China)

机构地区：[1]南方医科大学南方医院整形外科,广东广州510080

出　　处：《中国美容整形外科杂志》2018年第8期449-451,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨利用耳后推进皮瓣联合耳甲软骨支撑法矫正重度隐耳畸形的临床效果。方法自2015年3月至2017年11月,对收治的11例15只重度隐耳畸形患者进行手术矫正。设计耳后V形推进皮瓣,彻底松解耳郭上极软骨间的粘连,广泛剥离耳后及乳突区皮肤,形成"乳突区皮瓣"并向上推进;切取新月形耳甲软骨,支撑对耳轮上脚;采用垂直褥式缝合,纠正耳舟畸形。结果本组15只患耳,除1只因包扎不当致V形皮瓣蒂部出现小范围表皮坏死外,余者术后无出血、感染和皮瓣坏死等并发症发生。术后随访3~24个月,矫正耳郭结构清晰,形态自然,均获得了较满意的效果。结论耳后推进皮瓣联合耳甲软骨支撑法是矫正重度隐耳畸形的一种有效方法。Objective To explore the clinical efficacy of the retroauricular advancement skin flap associated with the concha auriculae cartilage support method in the correction of severe cryptotia malformation. Methods From March 2015 to November 2017, 11 patients with 15 cryptotia malformations were enrolled for surgical correction. For each patient＇s treatment a retroauricular V-shape advancement skin flap was designed, and the adhesion between the cartilage of the auricular superior pole was completely loosened. The skin of the post aurem and the mastoid area was extensively peeled off, and a ＂mastoid area flap＂ was formed and pushed upward. In the next step, a crescent chondroid cartilage was cut to support the upper crust of the antihelix. A vertical mattress suture was performed to correct the deformity of the fossae helicis. Results There were a total of 15 deformed ears. No postoperative complications such as bleeding, infection, or necrosis of the skin flap occurred except in one case in which a small range of epidermis necrosis of the V-shape skin flap pedicle appeared due to improper bandaging. After follow-up from 3 to 24 months, the structure of the auricle was clear and the appearance was natural. All patients achieved satisfactory results. Conclusion The retroauricular advancement skin flap associated with the concha auriculae cartilage support method is an effective method to correct severe cryptotia malformation.

关 键 词：耳郭畸形 隐耳 推进皮瓣 耳软骨 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]